Determining the Impact of Swallowing Impairment in People recovering from Severe COVID-19 Infection

项目摘要/摘要 最近新冠肺炎的传播已导致一场国际大流行，迄今已有400万例确诊病例 在全球范围内，其中美国报告了130万例确诊病例和8万例死亡。受感染的 个人通常经历严重的呼吸困难和肺炎，导致入院治疗。 以及重症监护和机械通风的必要性。新出现的证据表明，味觉受损 气味可能是这种疾病的早期标志，在严重的情况下，可能会有神经损伤 在延髓中，控制呼吸和吞咽的重要脑干部位。给定 呼吸和吞咽的重叠神经解剖学调节，我们假设吞咽困难 (吞咽障碍)将在严重新冠肺炎(PRSC-19)和 与较差的结果相关。通过这项赠款补充，我们建议扩大我们现有的工作 研究不同临床人群吞咽困难的特征，研究吞咽困难及其对PRSC的影响。 19.为了了解在PRSC-19中吞咽困难的患病率和病理生理，我们将进行详细的 重症监护标准实施期间、出院后电视透视检查结果分析 在急性护理环境中的常规医疗护理单元。考虑到目前在执行 对新冠肺炎检测阳性的住院患者进行吞咽评估，我们还将建立3个地区 研究诊所将为急性出院后的PRSC-19提供全面的吞咽评估 关爱康复或社区。这些评估将包括收集病历。 信息，视频透视，使用新型数字听诊器测量呼吸-吞咽 协调性、吞咽困难其他危险因素的测量(例如，球肌肉力量)和患者报告 结果。对视频荧光显微镜的详细分析将确定吞下那次坠落的具体措施 超出正常变化范围，基于与通过 我们的研究计划探索在不同浓度的液体上的吞咽生理。

Project Summary/Abstract The recent spread of COVID-19 has led to an international pandemic, with >4 million confirmed cases to date worldwide, of which >1.3 million confirmed cases and >80,000 deaths have been reported in the USA. Infected individuals commonly experience severe respiratory difficulties and pneumonia, leading to hospital admission and the need for intensive care and mechanical ventilation. Emerging evidence suggests that impaired taste and smell may be early markers of the disease, and that in severe cases, there may be neurological damage in in the medulla, an important brainstem control site for both respiration and swallowing. Given the overlapping neuroanatomical regulation of breathing and swallowing, we hypothesize that dysphagia (swallowing impairment) will be common in People recovering from Severe COVID-19 (PrSC-19) and associated with poorer outcomes. Through this grant supplement, we propose to extend our existing work characterizing dysphagia profiles in different clinical populations to study dysphagia and its impact in PrSC- 19. To understand the prevalence and pathophysiology of dysphagia in PrSC-19, we will conduct detailed analyses of videofluoroscopies performed during the standard of care, post-discharge from intensive care to regular medical care units within the acute care setting. Given the current limitations in performing swallowing assessments for inpatients who test positive for COVID-19, we will also establish 3 regional research clinics that will offer comprehensive swallowing assessments to PrSC-19 after discharge from acute care to rehabilitation or the community. These assessments will include the collection of case history information, videofluoroscopy, use of a novel digital stethoscope to measure respiratory-swallow coordination, measures of other risk factors for dysphagia (e.g. bulbar muscle strength) and patient-reported outcomes. Detailed analyses of the videofluoroscopies will identify specific measures of swallowing that fall outside the range of normal variation based on comparison to healthy reference values established through our research program exploring swallowing physiology on liquids of different consistencies.